Method and interface for operating a VDOV endoscope

ABSTRACT

A method and system are provided for configuring a variable direction of view endoscope, generally comprising a video display screen and an endoscope having a view controlling device for moving the view vector between predefined, discrete view vector positions. The video display screen displays a set of these view vector positions, and the view vector is moved from one of these positions directly to another in response to a command from a user via the video display screen.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.11/052,180 filed Feb. 7, 2005, now U.S. Pat. No. 7,427,263, which claimsthe benefit under 35 U.S.C. §119(e) of U.S. Provisional PatentApplication No. 60/549,838 filed on Mar. 3, 2004. All prior applicationsare herein incorporated by reference in their entirety.

FIELD OF THE INVENTION

The present invention relates to endoscopes and specifically to theoperation of variable direction of view endoscopes.

BACKGROUND OF THE INVENTION

Traditionally rigid endoscopes have a fixed viewing direction. Dependingon the endoscope, the viewing direction can be either straight forwardalong the longitudinal axis of the scope, or it can be set at an angleto the longitudinal axis. A variety of off-angles are availabledepending on the application. For example, in sinoscopy typical scopeangles can be 0, 30, 45, 70, and 90, while in cystoscopy the angles aretypically 0, 30, 70, and 120. The endoscopist needs this range of anglesin order to maximize the visual coverage of an internal structure. Withonly a straight forward viewing scope, the viewing range is severelylimited. In large cavities, such as the abdomen, the operator cancompensate for a fixed forward viewing angle by changing the entry angleof the laparoscope, and can thus with skilled manipulation increase theviewing range somewhat. However, in many cases, such as neuroendoscopy,sinoscopy, or otoscopy, the endoscope shaft is physically constrained ormust remain largely stationary to avoid injuring the patient.

There are a number of drawbacks with using multiple endoscopes ofdifferent angles. Firstly, and most critically, inserting an off-angleendoscope can be dangerous because the operator can not see forwardwhile the scope is being inserted. This problem is so severe that inneuroendoscopy for example, many surgeons will not use off-angleendoscopes because they are afraid of damaging delicate brain tissue.The result of this is regularly missed tumors growing outside the visualrange. Similarly, in cystoscopy and certain types of laparoscopy, thesurgeons are often concerned with using off-axis scopes for fear ofinjuring tissue ahead of or behind the viewing side of the scope.Secondly, each time a scope must be retracted and replaced with a scopeof different a viewing angle, the operator can lose orientation andestablished visual reference points. Thirdly, repeated insertions andretractions are time consuming and annoying. Finally, the preparation,storage, and cleaning required for multiple endoscopes is impractical.There is also significant additional cost associated with having tosupply multiple endoscopes for each procedure.

There have been a number of attempts to design variable direction ofview endoscopes which can change their line of sight in situ and thusremove the need for multiple instruments. Examples of such devices aredisclosed in U.S. Pat. No. 3,856,000 to Chikama, U.S. Pat. No. 6,371,909to Hoeg, U.S. Pat. No. 6,560,013 to Ramsbottom, U.S. Pat. No. 4,697,577to Forkner, U.S. Pat. No. 6,500,115 to Krattiger et al., and U.S. Pat.No. 5,762,603 to Thompson, which mechanically or electromechanicallychange the viewing direction, and in U.S. Pat. No. 5,313,306 to Kuban,and U.S. Pat. No. 5,800,341 to McKenna et al., which electronicallychange the viewing direction within a large captured field. Theseendoscopes can be disorienting and difficult to control. Hale et al. inU.S. Pat. No. 6,663,559 solve these control and orientation problems bycomputer-aided navigation. While effective, the advanced capabilitiesafforded by Hale et al. are not always necessary, especially when doingcertain types of diagnoses. While the methods taught by Hale et al.appear to be the future direction of endoscopy, most surgeons forexample, have been trained to use endoscopes with fixed viewing anglesand are therefore sometimes reluctant to adopt new endoscopic viewingtechniques. Specifically, many surgeons have come to rely on thespecific viewpoints provided by fixed angle scopes. Rather thanendoscopically navigating a cavity attempting to correlate the view witha preexisting knowledge of what the anatomy should look like, surgeonstend to associate a certain endoscopic viewing angle with a certain viewand have developed mental links between viewing reference points andscope types. They have also become accustomed to correlating theposition of structural features on the endoscope, such as the lightpost, with the orientation and direction of the endoscopic view. Theseestablished mental couplings between the endoscope configuration and thelive image have become and important part of the endoscopic viewingprocess and are therefore difficult to reform.

Accordingly, the object of the present invention is to provideendoscopists with the advantages of traditional fixed-angle endoscopywhile avoiding the disadvantages of using multiple instruments. Stillfurther objects and advantages will become apparent from the ensuingdescription and drawings.

SUMMARY OF THE INVENTION

In accordance with the present invention, a variable direction of viewendoscope can be configured to allow rapid switching between discreteviewing directions.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 schematically illustrates a series of fixed-angle endoscopesconstituting a cystoscopic suite.

FIG. 2 shows the tip of a traditional variable direction of viewendoscope.

FIG. 3 shows the operation of a variable direction of view endoscopeaccording to the preferred embodiment of the present invention.

FIGS. 4A, 4B, 4C and 4D give examples of various control interfacesaccording to the present invention.

FIG. 5 shows a graphical user interface according to the presentinvention.

DETAILED DESCRIPTION OF THE INVENTION

The following detailed description illustrates the invention by way ofexample, not by way of limitation of the principles of the invention.This description will enable one skilled in the art to make and use theinvention, and describes several embodiments, adaptations, variations,alternatives and uses of the invention, including what we presentlybelieve is the best mode of carrying out the invention.

Prior Art Devices

Referring now to the drawings, in which like reference numbers representsimilar or identical structures throughout, FIG. 1 shows a set offixed-angle endoscopes 10 with viewing directions of 0, 30, 70, and 120degrees. Along with the traditional forward view, a 30 degree offset isoften popular because it affords simultaneous straight forward andlateral viewing. Greater angles of 70 and 120 provide lateral and nearretrospective viewing. Together these scopes 10 make up an endoscopesuite as currently used in cystoscopy and neuroendoscopy. Other standardviewing angles include 12, 45, and 90 degrees.

FIG. 2 shows a common variable direction of view endoscope 10 with aview vector 12 which can swing through a range 14. The size of thisrange depends on the particular construction of the endoscope 10. Somevariable direction of view scopes have a detent which settles the viewvector 12 stably into a specific angular position 16, here 90 degreeslateral, effectively transforming the scope into a fixed off-anglescope. This detent keeps the view vector 12 from drifting away from atrue 90 degree angle when the scope is manipulated. The drawback withthis mechanism is that the detent cannot be repositioned if the userdesires a different fixed angle, and the overall design also does notlet the user reconfigure the scope 10 to add or subtract other fixedangles depending on the application.

Preferred Embodiment

In the preferred embodiment shown in FIG. 3, a variable direction ofview endoscope 10 with a scan range 14 is configured to have its line ofsight move between discrete angular positions 0, 30, 70, and 120degrees. The scope 10 was previously configured to move between adifferent set of angles: 0, 12, 45, and 90 degrees. Any set of anglescan be specified, and with a continuously variable viewing direction asmany discrete positions as desirable can be set by the user according tothe specific application or need. Depending on the construction of theendoscope 10, this can be done mechanically by adjusting a physicalsetting or electronically by programming the device. Mechanicalconfiguration is accomplished with a standard transmission where aclutch can be used to shift the rotation rates, as with stick-shiftedcars or revolving spindle machines like lathes or mills (Thetransmission and actuation techniques are not shown as there is a wealthof well known mechanisms suitable for the purpose of the presentinvention.). There could for example be three settings; continuoussmooth motion, 30 degree increments, and 45 degree increments. Dependingon the complexity of the transmission mechanism, combinations ofdifferent settings could also be possible. With an electronic orelectromechanical endoscope it is possible to reconfigure the endoscopeelectronically (simple common support circuitry can be added ifnecessary). This would be done simply by programming the device, muchlike one would set preferences in consumer electronics, such asprogramming favorite radio stations or one-touch phone dialing, etc.Setting the desired angles could either be done with input buttonsdirectly on the endoscope or it could be done through the graphical userinterface (described below). Depending on the electronic configurationof the device, any number of angles can be stored, and the angles can beset to any value. The user can then rapidly switch between these presetangles without the time, thought, and effort normally required to adjustthe endoscopic viewing direction. It is also possible to rapidly switchbetween programmed sets of preset angles, say from a standard cystoscopyset to a standard sinoscopy set. A further valuable feature is that thescope 10 can be configured so that certain button presses or doubleclicks take the view vector 12 to a preset home position and bypassintervening angles for rapid toggle between home and a desired viewingangle (described further below). Also, if desired, the scope 10 canalways be switched into continuous mode where the angle of the viewvector 12 is smoothly variable.

Once configured, a series of input devices can be used for controllingthe endoscopic viewing direction: FIG. 4A shows a wheel 18 which can beactuated by the user's thumb (or other appropriate finger). Thisthumb-wheel 18, located on the endoscope handle 19, is configured tosettle into discrete positions, much like a tuning knob on a digitalradio. A pointer 20 could also be used. Such a pointer 20 could eitherserve as a control input or be passively attached to a knob orthumb-wheel 18. Aligned with the endoscopic view vector (not shown), thepointer 20 provides an important indication to the operator about wherethe endoscope 10 is “looking” (See U.S. Pat. No. 6,695,774 to Hale etal.). A clutch 22 is used for shifting the transmission ratio betweenthe thumb wheel 18 and the view vector. Other mechanical input meansinclude handles, triggers, or variable increment knobs 23, as shown inFIG. 4B. Variable increment knobs are typically found on radio tuners,oscilloscopes, and micrometers, where knobs engage differenttransmission ratios depending on axial position, or where there areseveral coaxial knobs which each engage a different setting. For anelectronic or electromechanical endoscope, the input device is ajoystick 24 or similar electronic switch/button, shown in FIG. 4C. Bypushing the joystick 24 forward or backward, the endoscopic view vectorposition is incremented or decremented to an adjacent angularconfiguration. Depressing the joystick 24 or moving it right or leftperforms additional functions, such as putting the device into set modeand adjusting settings in this mode. The device can also be configuredto toggle between angular positions which are not adjacent, depending onthe dynamic needs of the operator. In particular, toggling betweenstraight forward and an off-angle is very useful. During endoscopicprocedures surgeons often get disoriented and would like to be able torapidly return the view to a home position for a reference check. Thebest reference view is normally straight forward as it is the one towhich the surgeon can most easily relate. This type of immediate returnto a home reference is not possible with current endoscopes but can bedone with the present invention. Double-clicking the joystick 24 forexample, causes a return to home and/or there could also be a designatedhome-button 26, as in the alternative button based interface shown inFIG. 4D (top view). A set-button 28 which puts the device in set mode isalso included in this interface, along with forward and backward buttons30, 32. Generally, a wide range of interface configurations arepossible, as exemplified by the multitude of different available videogame joysticks and keypads. Which one is used will depend on theergonomic requirements for different users and situations.

In its preferred embodiment, the present invention includes a graphicaluser interface (GUI) for controlling the endoscopic viewing process.This GUI, shown in FIG. 5, comprises a main section 34 for displayingthe endoscopic image 36, and a section for selecting viewing parameters38. For example, a set of default angular settings according to surgicalprocedure are available, allowing the user to choose the appropriate setof angles for a given procedure. A neurosurgeon would select aneurosurgical setting which runs the scope in the default multi-modeconstituting the angles 0, 30, 70, and 120 degrees. An ear-nose-throatsurgeon would select a sinoscopy setting which provides default viewingangles of 0, 30, 45, 70, and 90 degrees. The GUI also allows the user tocustomize settings, with specific toggles between angles, and personallypreferred home positions for the endoscope. It also displays the currentviewing angle 40, which allows the user to run a combination ofcontinuous mode and discrete mode: the scope can be operated with asmoothly variable viewing angle, but the user will also know the runningangle and can thus manually move the scope to specific desired angleswithout being tied to discrete preprogrammed positions. The viewingangle can also be displayed on a small readout, display, or dial locatedon the endoscope itself, but this is less useful because during aprocedure it is inconvenient to have to look at the endoscope to get thecurrent viewing angle. Further features give the user the choice ofenabling advanced navigation features such as gravity leveling of theendoscopic image (provided the endoscope in use is equipped with theappropriate instrumentation) and superimposition of custom or defaultreference coordinate systems 42.

Accordingly, the present invention provides a method and interface forproviding endoscopists with the advantages of traditional fixed-angleendoscopy while avoiding the disadvantages of using multipleinstruments. It also provides other advantages such as rapid togglingbetween views and immediate return to home reference positions.

The present invention has been described above in terms of a presentlypreferred embodiment so that an understanding of the present inventioncan be conveyed. However, many alternative designs, interfaces,configurations, and structural arrangements are possible withoutdeparting from the principle of the invention. The scope of the presentinvention should therefore not be limited by the embodimentsillustrated, but rather it should be understood that the presentinvention has wide applicability with respect to multi-directionalviewing instruments and their use, which can be industrial or medical.All modifications, variations, or equivalent elements andimplementations that are within the scope of the appended claims shouldtherefore be considered within the scope of the invention.

1. A method for operating a variable direction of view endoscope, themethod comprising: providing an endoscope with a view controlling devicethat moves a variable view vector of the endoscope between a pluralityof discrete view vector positions relative to the endoscope; displayinga set of the predefined, discrete view vector positions on a videodisplay screen; supplying a command via the video display screen thatcauses the view controlling device to move the view vector to a firstone of the discrete view vector positions displayed on the video displayscreen; and supplying a command via the video display screen that causesthe view controlling device to move the view vector directly from thefirst discrete view vector position to a second one of the discrete viewvector positions displayed on the video display screen.
 2. The method ofclaim 1, further comprising selecting particular discrete view vectorpositions from among the view vector positions displayed on the videodisplay screen.
 3. The method of claim 2, wherein the step of selectingparticular discrete view vector positions includes selecting the set ofdiscrete view vector positions from among a plurality of predefined setsof discrete view vector positions.
 4. The method of claim 3, wherein theplurality of predefined sets of discrete view vector positionscorrespond to a plurality of procedure types.
 5. The method of claim 3,wherein the plurality of predefined sets of discrete view vectorpositions correspond to a plurality of users.
 6. The method of claim 1,further comprising displaying a graphical representation of the currentposition of the view vector relative to the endoscope on the videodisplay screen.
 7. The method of claim 1, further comprising displayinga number that represents the current angle between the view vector andthe longitudinal axis of the endoscope on the video display screen. 8.The method of claim 1, wherein the endoscope has a longitudinal axis,and the set of discrete positions displayed on the video display screenincludes a position in which the view vector is generally parallel tothe longitudinal axis.
 9. The method of claim 8, wherein the view vectoris moveable to the position in which the view vector is generallyparallel to the longitudinal axis directly from any other positiondisplayed on the video display screen.
 10. The method of claim 9,wherein the view vector is movable to any position displayed on thevideo display screen directly from the position in which the view vectoris generally parallel to the longitudinal axis.
 11. The method of claim1, wherein the view vector can toggle between the position in which theview vector is generally parallel to the longitudinal axis and any otherposition displayed on the video display screen.
 12. The method of claim1, wherein: the view vector has an attendant field of view; and thefield of view when the view vector is in the first position overlaps thefield of view when the view vector is in the second position.
 13. Asystem for operating a variable direction of view endoscope, comprising:a video display screen; and an endoscope having a variable view vector,wherein said endoscope includes a view controlling device that moves theview vector between a plurality of discrete view vector positionsrelative to said endoscope; wherein said video display screen displays aset of the discrete view vector positions to a user; wherein the set ofdiscrete view vector positions displayed on said video display screenincludes a first discrete position to which the view controlling devicemoves the view vector to a first discrete position in response to afirst command supplied by a user via said video display screen; andwherein the set of discrete view vector positions displayed on saidvideo display screen further includes a second discrete position towhich the view controlling device moves the view vector directly fromthe first discrete position to the second discrete position in responseto a second command supplied by a user via said video display screen.14. The system of claim 13, wherein said video display screen displays aplurality of set identifiers corresponding to a plurality of predefinedsets of the discrete view vector positions from which a user can selectthe set of discrete view vector positions displayed on said videodisplay screen.
 15. The system of claim 14, wherein the plurality ofpredefined sets of discrete view vector positions correspond to aplurality of procedure types.
 16. The system of claim 14, wherein theplurality of predefined sets of discrete view vector positionscorrespond to a plurality of users.
 17. The system of claim 13, whereinsaid video display screen displays a graphical representation of thecurrent position of the view vector relative to said endoscope.
 18. Thesystem of claim 13, further comprising displaying a number thatrepresents the current angle between the view vector and thelongitudinal axis of said endoscope on said video display screen. 19.The system of claim 13, wherein said endoscope has a longitudinal axis,and the set of discrete positions displayed on said video display screenincludes a position in which the view vector is generally parallel tothe longitudinal axis.
 20. The system of claim 19, wherein the viewvector is moveable to the position in which the view vector is generallyparallel to the longitudinal axis directly from any other positiondisplayed on said video display screen.
 21. The system of claim 20,wherein the view vector is moveable to any position displayed on saidvideo display screen directly from the position in which the view vectoris generally parallel to the longitudinal axis.
 22. The system of claim13, wherein the view vector can toggle between the position in which theview vector is generally parallel to the longitudinal axis and any otherposition displayed on said video display screen.
 23. The system of claim13, wherein: the view vector has an attendant field of view; and thefield of view when the view vector is in the first position overlaps thefield of view when the view vector is in the second position.